What if I can’t, or don’t, get treated under Access Gap?

If a specialist doesn’t treat you under Access Gap, we (together with Medicare) will pay the government set fee for your treatment. These fees are laid out in the Medicare Benefits Schedule (MBS).

If your specialist charges more than the MBS fee, you’ll have to pay the difference (or ‘gap’).

Either way, be sure to get a written breakdown of all the estimated costs. Understanding the full cost of your treatment is called Informed Financial Consent.